Upper Delaware Ambulance Corps Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

10005 Issued in NY

Legal business name

UPPER DELAWARE AMBULANCE CORPS INC

Practice address

26 Kellam Bridge Rd
Hankins, NY 12741-5002

Phone

(315) 635-1789

NPI assigned

Jul 3, 2006

Last updated

Dec 12, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Frederick Knack

Title

President

Phone

(845) 887-6070

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1154350841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 535",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130270535",
            "telephone_number": "315-635-1789",
            "fax_number": "315-635-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 KELLAM BRIDGE RD",
            "city": "HANKINS",
            "state": "NY",
            "postal_code": "127415002",
            "telephone_number": "315-635-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER DELAWARE AMBULANCE CORPS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "KNACK",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-887-6070"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NY",
            "license": "10005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "9611703",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01812106",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "4190489",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RR MEDICARE",
            "identifier": "590013548",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Joseph Breslin, RNFA
• Kara Elizabeth Spath

• Ambulance in Hankins, NY
• Providers in Hankins, NY by specialty
• Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.